Instrumentality in local actions of health surveillance

This article is part of a doctoral thesis that uses both Symbolic Interactionism as a theoretical framework, and Grounded Theory as a method, to understand the interpretations and meanings attributed to the instruments used in local actions of health surveillance; also to comprehend how these instruments interfere with risk identification and decision-making processes of interventions. The professional uses a set of empirical techniques and instrumental references that allow him to interpret possibilities for actions and situational conditions. Using health legislation, knowledge, and experience, the professional identifies and assesses the risk. These instruments structure knowledge and actions, rationally composing an objectified process using technical knowledge and critical interpretations; this nonetheless involves subjective decisions based on experience and interpretations. The intervention is the representation of the existence of risk and of protective measures. It is set in a specific context, constituting a system aiming to modify a problematic situation. It is not enough to identify the risk, but to define how and what means can be mobilized to control it. Intervening constitutes therefore a scientific and political challenge for the professional.